DESCRIPTION: (Provided by the Applicant) The cause of the well-documented African American-white disparity in the distribution of healthcare services continues to be elusive. Interpersonal racial dynamics seem to operate in medical encounters, but the mechanisms are unclear. One mechanism may be found with patients. Patients' racial attitudes may ultimately affect patients' perception and evaluation of clinicians. My long-term goal is to contribute to the elimination of racial disparities in medical treatment. The goal of this application is to determine how racial attitudes affect patients' perception and evaluation of clinicians. Two specific aims will be pursued: 1. Determine how negative racial attitudes are applied to attitudes about clinicians. The working hypothesis is that negative racial attitudes are applied to attitudes about working with different-race and nationality clinicians. 2. Determine how patients' racial attitudes affect evaluation of encounters with same- and different-race clinicians. The working hypothesis is that negative racial attitudes partially account for negative evaluation of different-race clinicians. In order to test these working hypotheses, survey data will be collected and analyzed. The limited number of existing studies suggest that doctors' racial attitudes can affect the medical encounter. The proposed work is innovative because it asks how patients' racial attitudes affect medical interactions. Explication of the relationship between racial attitudes and perception of clinicians is important because it will provide information about the extent to which patients' racial beliefs about clinicians are formed outside the healthcare system. The proposed research is significant because it will provide heretofore missing information about how the racial thinking of patients affects perceptions and evaluations of clinicians. This may be a critical step in addressing racial disparities in healthcare because evaluation of the clinician is associated with continuity of care, delays in seeking care and other important health behaviors. Because there are fewer African American clinicians, this effect would be more detrimental to African Americans than whites. The results of this study are expected to aid in the development of strategies that reduce the likelihood of racial attitudes impeding patient-clinician communication. Such interpersonal changes would be expected to improve the quality of care and reduce inequity in medical treatment.